Cimetidine and Ramelteon interaction
Cimetidine and Ramelteon: the Ramelteon prescribing label flags this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Ramelteon (Rozerem) label · effective 2026-04-15
Fluvoxamine (strong CYP1A2 inhibitor): Increases AUC for ramelteon and should not be used in combination.
Ketoconazole (strong CYP3A4 inhibitor): Increases AUC for ramelteon; administer with caution.
Effects of Other Drugs on ROZEREM Fluvoxamine (strong CYP1A2 inhibitor) AUC 0-inf for ramelteon increased approximately 190-fold, and the C max increased approximately 70-fold upon coadministration of fluvoxamine and ROZEREM, compared to ROZEREM administered alone.
ROZEREM should be administered with caution to patients taking less strong CYP1A2 inhibitors.
Ketoconazole (strong CYP3A4 inhibitor) The AUC 0-inf and C max of ramelteon increased by approximately 84% and 36% upon coadministration of ketoconazole with ROZEREM.
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